Heart failure & cardiomyopathiesRandomised controlled trial
Withdrawal of heart failure therapy after atrial fibrillation rhythm control with ejection fraction normalization: the WITHDRAW-AF trial
- Randomised controlled trial
- multicentre
- crossover
Authors' conclusion
Withdrawal of HF therapy following AF rhythm control for prior AFCM and recovered LVEF was not associated with a decline in LVEF for most patients in the following 6 months.
Study context
- Population
- AF-mediated cardiomyopathy with left ventricular ejection fraction (LVEF) normalization after AF rhythm controlall completed 12-month follow-up
- Participants
- 60 participants
- Comparison
- Group A vs Group B
- Primary endpoint
- CMR LVEF maintenance ≥50%
- Follow-up
- 6 months
Primary result
CMR LVEF maintained ≥50%
Odds ratio
1.18
95% CI 0.27–2.82
P = 0.47
By group
Group A vs Group B
OR 1.18 (95% CI 0.27–2.82); P = 0.47
As reported in the abstract
Secondary outcomes
CMR LVEF at end of randomization phase
P = 0.236
- CMR LVEF at end of randomization phase — CMR LVEF similar across study time points
- mixed effects P = .37
Echocardiography, NT-proBNP, functional status, quality of life, AF burden
- Similar on vs off heart failure (HF) therapy in the overall population
Original publication
Withdrawal of heart failure therapy after atrial fibrillation rhythm control with ejection fraction normalization: the WITHDRAW-AF trial. Eur Heart J. Published 12 August 2025. doi:10.1093/eurheartj/ehaf563
Summarised from the published abstract; every number is checked against it